Open versus laparoscopic portal lymphadenectomy in gallbladder cancer: is there a difference in lymph node yield?

Ong, Cecilia T; Leung, Kenneth; Nussbaum, Daniel P; Sun, Zhifei; Gloor, Beat; Blazer, Dan G; Worni, Mathias (2018). Open versus laparoscopic portal lymphadenectomy in gallbladder cancer: is there a difference in lymph node yield? HPB : official journal of The International Hepato-Pancreato-Biliary Association, 20(6), pp. 505-513. Elsevier 10.1016/j.hpb.2017.10.015

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BACKGROUND Gallbladder cancer (GBC) is the most common biliary tract malignancy. Because it commonly metastasizes via lymphatics, portal lymphadenectomy should be included in oncologic resections. This study aimed to compare the oncologic equivalence of the laparoscopic versus open technique by evaluating lymph node (LN) yield. METHODS The 2010-2012 National Cancer Data Base identified patients who underwent laparoscopic or open resection of GBC with dedicated lymphadenectomy. LN yield was compared by resection method. Variables associated with LN yield ≥3 were identified. RESULTS Of 1524 patients identified, 52% were intended to undergo laparoscopic surgery, with 20% of these patients converted to open. Collection of ≥3 LNs following open resection (47%) was higher than for laparoscopic resection (34%), p < 0.001. Operations performed at high-volume (aOR:1.74, p < 0.001) and/or academic centers (aOR:1.70, p = 0.024) had superior LN yield. LN yield was not associated with overall survival (aHR:0.93, p = 0.493). CONCLUSIONS In this analysis of national data, LN yield following laparoscopic resection for GBC was significantly lower than following open resection. Open resection is more frequently performed at academic centers, possibly to assure adequate oncologic resection. Enforcing consensus guidelines for lymphadenectomy in gallbladder cancer will optimize outcomes as minimally invasive approaches evolve.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Viszeralchirurgie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Viszeralchirurgie

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery

UniBE Contributor:

Gloor, Beat and Worni, Mathias

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1365-182X

Publisher:

Elsevier

Language:

English

Submitter:

Lilian Karin Smith-Wirth

Date Deposited:

27 Mar 2019 16:38

Last Modified:

23 Oct 2019 12:44

Publisher DOI:

10.1016/j.hpb.2017.10.015

PubMed ID:

29472106

BORIS DOI:

10.7892/boris.125777

URI:

https://boris.unibe.ch/id/eprint/125777

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